Sensory modality and spoken language shape reading network in blind readers of Braille

Impaired Ability in Visual-Spatial Attention in Chinese Children With Developmental Dyslexia

A growing body of evidence suggests that children with dyslexia in alphabetic languages exhibit visual-spatial attention deficits that can obstruct reading acquisition by impairing their phonological decoding skills. However, it remains an open question whether these visual-spatial attention deficits are present in children with dyslexia in non-alphabetic languages. Chinese, with its logographic writing system, offers a unique opportunity to explore this question. The presence of visual-spatial attention deficits in Chinese children with dyslexia remains insufficiently investigated. Therefore, this study aimed to explore whether such deficits exist, employing a visual search paradigm. Three visual search tasks were conducted, encompassing two singleton feature search tasks and a serial conjunction search task. The results indicated that Chinese children with dyslexia performed as well as chronological age-matched control children in color search tasks but less effectively in orientation search, suggesting a difficulty in the rapid visual processing of orientation: a deficit potentially specific to Chinese dyslexia. Crucially, Chinese children with dyslexia also exhibited lower accuracy, longer reaction times, and steeper slopes in the reaction times by set size function in the conjunction search task compared to control children, which is indicative of a visual-spatial attention deficit.

The role of the left ventral occipitotemporal cortex in speech processing-The influence of visual deprivation

The role of the left ventral occipitotemporal cortex (vOT) in reading is well-established in both sighted and blind readers. Its role in speech processing remains only partially understood. Here, we test the involvement of the left vOT in phonological processing of spoken language in the blind (N = 50, age: 6.76-60.32) and in the sighted (N = 54, age: 6.79-59.83) by means of whole-brain and region-of-interest (including individually identified) fMRI analyses. We confirm that the left vOT is sensitive to phonological processing (shows greater involvement in rhyming compared to control spoken language task) in both blind and sighted participants. However, in the sighted, the activation was observed only during the rhyming task and in the speech-specific region of the left vOT, pointing to task and modality specificity. In contrast, in the blind group, the left vOT was active during speech processing irrespective of task and in both speech and reading-specific vOT regions. Only in the blind, the left vOT presented a higher degree of sensitivity to phonological processing than other language nodes in the left inferior frontal and superior temporal cortex. Our results suggest a changed development of the left vOT sensitivity to spoken language, resulting from visual deprivation.

Decoding Reach Direction in Early "Visual" Cortex of Congenitally Blind Individuals

Motor actions, such as reaching or grasping, can be decoded from fMRI activity of early visual cortex (EVC) in sighted humans. This effect can depend on vision or visual imagery, or alternatively, could be driven by mechanisms independent of visual experience. Here, we show that the actions of reaching in different directions can be reliably decoded from fMRI activity of EVC in congenitally blind humans (both sexes). Thus, neither visual experience nor visual imagery is necessary for EVC to represent action-related information. We also demonstrate that, within EVC of blind humans, the accuracy of reach direction decoding is highest in areas typically representing foveal vision and gradually decreases in areas typically representing peripheral vision. We propose that this might indicate the existence of a predictive, hard-wired mechanism of aligning action and visual spaces. This mechanism might send action-related information primarily to the high-resolution foveal visual areas, which are critical for guiding and online correction of motor actions. Finally, we show that, beyond EVC, the decoding of reach direction in blind humans is most accurate in dorsal stream areas known to be critical for visuo-spatial and visuo-motor integration in the sighted. Thus, these areas can develop space and action representations even in the lifelong absence of vision. Overall, our findings in congenitally blind humans match previous research on the action system in the sighted, and suggest that the development of action representations in the human brain might be largely independent of visual experience.SIGNIFICANCE STATEMENT Early visual cortex (EVC) was traditionally thought to process only visual signals from the retina. Recent studies proved this account incomplete, and showed EVC involvement in many activities not directly related to incoming visual information, such as memory, sound, or action processing. Is EVC involved in these activities because of visual imagery? Here, we show robust reach direction representation in EVC of humans born blind. This demonstrates that EVC can represent actions independently of vision and visual imagery. Beyond EVC, we found that reach direction representation in blind humans is strongest in dorsal brain areas, critical for action processing in the sighted. This suggests that the development of action representations in the human brain is largely independent of visual experience.

Reading Braille by Touch Recruits Posterior Parietal Cortex

Blind readers use a tactile reading system consisting of raised dot arrays: braille/⠃⠗⠇. How do human brains implement reading by touch? The current study looked for signatures of reading-specific orthographic processes in braille, separate from low-level somatosensory responses and semantic processes. Of specific interest were responses in posterior parietal cortices (PPCs), because of their role in high-level tactile perception. Congenitally blind, proficient braille readers read real words and pseudowords by touch while undergoing fMRI. We leveraged the system of contractions in English braille, where one braille cell can represent multiple English print letters (e.g., "ing" ⠬, "one" ⠐⠕), making it possible to separate physical and orthographic word length. All words in the study consisted of four braille cells, but their corresponding Roman letter spellings varied from four to seven letters (e.g., "con-c-er-t" ⠒⠉⠻⠞. contracted: four cells; uncontracted: seven letters). We found that the bilateral supramarginal gyrus in the PPC increased its activity as the uncontracted word length increased. By contrast, in the hand region of primary somatosensory cortex (S1), activity increased as a function of a low-level somatosensory feature: dot-number per word. The PPC also showed greater response to pseudowords than real words and distinguished between real and pseudowords in multivariate-pattern analysis. Parieto-occipital, early visual and ventral occipito-temporal, as well as prefrontal cortices also showed sensitivity to the real-versus-pseudoword distinction. We conclude that PPC is involved in orthographic processing for braille, that is, braille character and word recognition, possibly because of braille's tactile modality.

Visual experience shapes functional connectivity between occipital and non-visual networks

Comparisons across adults with different sensory histories (blind vs. sighted) have uncovered effects of experience on human brain function. In people born blind visual cortices are responsive to non-visual tasks and show altered functional connectivity at rest. Since almost all research has been done with adults, little is known about the developmental origins of this plasticity. Are infant visual cortices initially functionally like those of sighted adults and blindness causes reorganization? Alternatively, do infants start like blind adults, with vision required to set up the sighted pattern? To distinguish between these possibilities, we compare resting state functional connectivity across blind (n = 30) and blindfolded sighted (n = 50) adults to a large cohort of sighted infants (Developing Human Connectome Project, n = 475). Remarkably, we find that infant secondary visual cortices functionally resemble those of blind more than sighted adults, consistent with the idea that visual experience is required to set up long-range functional connectivity. Primary visual cortices show a mixture of instructive effects of vision and reorganizing effects of blindness. Specifically, in sighted adults, visual cortices show stronger functional coupling with nonvisual sensory-motor networks (i.e., auditory, somatosensory/motor) than with higher-cognitive prefrontal cortices (PFC). In blind adults, visual cortices show stronger coupling with PFC. In infants, connectivity of secondary visual cortices is stronger with PFC, while V1 shows equal sensory-motor/PFC connectivity. In contrast, lateralization of occipital-to-frontal connectivity resembles the sighted adults at birth and is reorganized by blindness, possibly due to recruitment of occipital networks for lateralized cognitive functions, such as language.

Similarities and differences in the neural correlates of letter and speech sound integration in blind and sighted readers

Learning letter and speech sound (LS) associations is a major step in reading acquisition common for all alphabetic scripts, including Braille used by blind readers. The left superior temporal cortex (STC) plays an important role in audiovisual LS integration in sighted people, but it is still unknown what neural mechanisms are responsible for audiotactile LS integration in blind individuals. Here, we investigated the similarities and differences between LS integration in blind Braille (N = 42, age range: 9-60 y.o.) and sighted print (N = 47, age range: 9-60 y.o.) readers who acquired reading using different sensory modalities. In both groups, the STC responded to both isolated letters and isolated speech sounds, showed enhanced activation when they were presented together, and distinguished between congruent and incongruent letter and speech sound pairs. However, the direction of the congruency effect was different between the groups. Sighted subjects showed higher activity for incongruent LS pairs in the bilateral STC, similarly to previously studied typical readers of transparent orthographies. In the blind, congruent pairs resulted in an increased response in the right STC. These differences may be related to more sequential processing of Braille as compared to print reading. At the same time, behavioral efficiency in LS discrimination decisions and the congruency effect were found to be related to age and reading skill only in sighted participants, suggesting potential differences in the developmental trajectories of LS integration between blind and sighted readers.

Beyond the Visual Word Form Area - a cognitive characterization of the left ventral occipitotemporal cortex

The left ventral occipitotemporal cortex has been traditionally viewed as a pathway for visual object recognition including written letters and words. Its crucial role in reading was strengthened by the studies on the functionally localized "Visual Word Form Area" responsible for processing word-like information. However, in the past 20 years, empirical studies have challenged the assumptions of this brain region as processing exclusively visual or even orthographic stimuli. In this review, we aimed to present the development of understanding of the left ventral occipitotemporal cortex from the visually based letter area to the modality-independent symbolic language related region. We discuss theoretical and empirical research that includes orthographic, phonological, and semantic properties of language. Existing results showed that involvement of the left ventral occipitotemporal cortex is not limited to unimodal activity but also includes multimodal processes. The idea of the integrative nature of this region is supported by the broad functional and structural connectivity with language-related and attentional brain networks. We conclude that although the function of the area is not yet fully understood in human cognition, its role goes beyond visual word form processing. The left ventral occipitotemporal cortex seems to be crucial for combining higher-level language information with abstract forms that convey meaning independently of modality.